"The mind steadfastly refuses to behave locally, as contemporary scientific evidence is beginning to show. We now know, for example, that brain like tissue is found throughout the body.... So, even from the conservative perspective of modern neurochemistry, it is difficult if not impossible to follow a strictly local view of the brain."

In the conduct of medical research, the existence of mind/body interactions has over the years been treated as a sort of hindrance. Such interactions are often lumped under the somewhat disparaging name of the placebo response. "Placebo" is a Latin term whose original meaning is "I shall please," and it refers to the mysterious and uncharted mechanisms by which the power of suggestion can result in a physiological change.

Ironically, the very scientific methods championed by mainstream medicine in the testing of drugs have provided the greatest scientific support for the existence and power of the mind/body connection. In fact, the mechanisms involved are so formidable that the standard research procedure requires separating out their effects from those of the drug.

Hence the power of mind/body mechanisms has been examined and measured in virtually thousands of drug studies. It is in this sense that they have been verified and acknowledged by medical research to be a real and powerful phenomenon.

In the 1970s and 80s, researchers trained their sights more directly on these mechanisms. Herbert Benson, M.D., and his colleagues at Harvard Medical School led the way with the discovery of the relaxation response. This work has led to a cascade of findings about how mind/body mechanisms can be used for medically significant impact on hypertension, heartdisease, cancer, and other conditions.

Today, leading edge programs for both patients and professionals are now conducted at Harvard's Mind/BodyMedical Institute, New England Deaconess Hospital, Boston. And under Benson's direction, the institute is collaborating in the creation of other such programs at major medical centers around the nation.

In Benson's perspective, "We are part of mainstream medicine, we are not alternative. You might say that this was considered alternative years ago, but it is now mainstream."2

Taking Center Stage
Indeed he may be right. In early 1993, a widely reported study documented the surprising popularity of alternative medicine this country. Published in The New England Journal of Medicine and led by Harvard researcher David Eisenberg, M.D., the study found that one in three adults had used some form of unconventional medicine. Of the varieties reported, mind/body technique were the most frequently used.3The creation of the Office of Alternative Medicine at the National Institutes of Health followed a few months later. Shortly thereafter, mind/body medicine was brought into the living rooms of millions of Americans by a television series on PBS called Healing and the Mind, hosted by the popular journalist Bill Moyers.

The PBS series symbolized a highly visible milestone in the mainstreaming of what critics had previously considered a form of fringe medicine. Mind/body medicine (also known as behavioral medicine) is of course nothing new. The influence of the mind in healing is addressed in virtually every medical tradition, from the ancient teachings of Ayurveda to modern allopathy. What is new is the legitimization of research in this field to the point of government funding and the incorporation of mind/body programs into the offerings of major medical institutions, many of which are noted for their conservatism and scientific bent.

What is the emerging role of this work? Benson regards it as an integral part of comprehensive health care. He offers the metaphor of a three-legged stool: "One leg is pharmaceuticals, another is surgery, and the third is what you can do for yourself. Mind/body medicine is strengthening the third leg, integrated with the other two legs.4

Key Principles

The Biopsychosocial Perspective
In the late 1970s the eminent medical researcher George Engel of the University of Rochester made the bold statement that modern medicine needed a new way of thinking about health and illness.5 He proposed what he called the biopsychosocial model, in which health is the outcome of many factors interacting together. This provides the theoretical framework underpinning mind/body medicine.

In this view, health is not just a matter of "the drugs keeping up with the bugs." Rather, health is determined by an interaction among our genetic vulnerabilities; environmental inputs such as germs, viruses, or pollutants; psychological factors such as stress, lifestyle, attitudes, and behavior; and social factors such as supportive relationships, economic well-being, access to health care, and family and community patterns of behavior.

Turning Down the Dial on Pain

Jim is a forty-six-year-old assembly line worker who received a disc injury in his neck and developed a chronic pain syndrome involving head, neck, arm, and shoulder pain. He was referred by his physiatrist to Karen Carroll, a biofeedback clinician practicing in Waterloo, Iowa, for pain control.

Carroll used EMG, first for general muscular tension and then for muscular tension around the upper body and neck. Jim was able to discover a direct connection between his thoughts, his level of nervous system arousal, muscular tension, and eventually his pain level.

After eight sessions spaced progressively further apart and accompanied by home practice of breathing exercises and progressive relaxation, his headaches and neck pain completely disappeared. He was then able to use physical therapy to further strengthen his neck and shoulders, and subsequently returned to work. He stated, "I never really knew what it felt like to relax until now." According to Carroll, this case illustrates the benefits of commitment to self-regulation and daily practice at home for someone who was motivated to avoid medication and surgery if possible.

Engel's perspective is gradually penetrating the thinking of mainstream medicine. When we look at the big picture of all the factors that influence health, we can see that many are within our direct control. Along with this new way of thinking has come a growing openness and receptivity to the contributing of mind/body approaches.

Mind/Body Communication
Our thoughts and feelings influence the body via two kinds of mechanisms: the nervous system and the circulatory system. These are the pathways of communication between the brain and the rest of the body.

The brain reaches into the body via the nervous system. This allows it to send nerve impulses into all the body's tissues and influence their behavior. The brain can thus affect the behavior of the immune system with its nerve endings extending into the bone marrow (the birthplace of all white cells), the thymus, the spleen, and the lymph nodes.

It also reaches into all the glands of the endocrine system, all the bones, muscles, all the internal organs, and even the walls of veins and arteries. It can influence the behavior of the heart with its nerves penetrating the heart tissue, affecting heart rate and other aspects of the heart's functioning. The entire body is literally "wired" by the brain.

The brain is also a gland. It manufactures thousands of different kinds of chemicals and releases them into the bloodstream. These chemicals circulate throughout the body and influence the activity and behavior of all the body's tissues. The brain could be described as the ultimate apothecary, producing many more drugs than science has ever invented.

The cells of the body have receptors on their surfaces that function somewhat like satellite dishes. These receptors receive the chemical messages being released by the brain and respond accordingly.

Finally, the mind/body connection is a two-way street. In addition to sending messages into the body's tissues, it also receives feedback, both in the form of nerve impulses and its own receptors that sense what chemicals are being released by other tissues in the body.

Research into how the brain can influence immune responses has given rise to the new field called psycho-neuro-immunology (PNI). Findings in this field have brought great hope to people dealing with such difficult illnesses as cancer, AIDS, CFIDS (chronic fatigue immune dysfunction syndrome), and other immune-related diseases.

It is only a matter of time before similar acronyms are defined for other fields such as psycho-neuro-cardiology (PNC), the study of the mind-heart connection, or psycho-neuro-hematology (PNH), the study of how the mind can influence bloodrelated disorders, such as clotting problems in hemophilia.

The Power of the Mind/Body Connection
One of the most stirring stories about the power of the mind/body connection concerns a man diagnosed with terminal cancer. Reported by Dr. Bruno Klopfer in the Journal of Projective Techniques in 1957, it involved a man with metastatic cancer and tumors that had spread throughout his body. The patient had tried every available form of medicine and his condition had hopelessly deteriorated to the point where he was bedridden and gasping for air. His doctors agreed that he had only a few days to live. Then the man heard about an experimental drug called Krebiozen, which was in the process of being tested. He insisted on being included in the experimental trials. His doctors, feeling he had nothing to lose and would soon be dead anyway, out of compassion agreed to give him the experimental drug. To their amazement, the man's tumors soon began to shrink dramatically and he was discharged from the hospital.

Two months later, the man read news accounts of the research on Krebiozen that reported serious doubts with the drug. Within a matter of days, the man's tumors had returned and were again threatening his life. His doctor cleverly convinced him that new and more potent shipment had been received and proceeded to give him injections of plain water. His tumors once again began to shrink dramatically. He remained healthy for seven more months until another news report declared "Nationwide AMA Tests Show Krebiozen to Be Worthless as a Cancer Treatment." The man died within two days.6

The Stress Response
The stress response is a set of changes in the body that result when the person experiences what they perceive to be a challenging or threatening situation. This matter of perceived threat is important because the effects of the stress response on the body are the same whether the threat is real or just imagined in the mind.

The magnitude of these changes is influenced by how serious the person thinks the situation is and what they think about their ability to handle the threat effectively (their appraisal of their ability to respond). Of course, the more confident the person is in their ability to handle a challenge easily, the less stress is involved. The more the person appraises the challenge as a threat—even at the subconscious level—the more intense will be the stress response.

Commonly called the fight-or-flight reaction, the stress response has the beneficial effect of preparing the body to function at a higher level of efficiency, which of course enhances the likelihood of survival. The physiological changes include:

William Collinge, PhD, MPH is a consultant, author, speaker and researcher in the field of integrative health care. He has served as a scientific review panelist for the National Institutes of Health in mind/body......more

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